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Urinary Bladder Neoplasms: HELP
Articles by Declan G. Murphy
Based on 8 articles published since 2010
(Why 8 articles?)
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Between 2010 and 2020, Declan Murphy wrote the following 8 articles about Urinary Bladder Neoplasms.
 
+ Citations + Abstracts
1 Guideline Robot-assisted radical cystectomy and urinary diversion: technical recommendations from the Pasadena Consensus Panel. 2015

Chan, Kevin G / Guru, Khurshid / Wiklund, Peter / Catto, James / Yuh, Bertram / Novara, Giacomo / Murphy, Declan G / Al-Tartir, Tareq / Collins, Justin W / Zhumkhawala, Ali / Wilson, Timothy G / Anonymous790818. ·City of Hope Cancer Center, Duarte, CA, USA. Electronic address: kchan@coh.org. · Roswell Park Cancer Institute, Buffalo, NY, USA. · Karolinska Institute, Stockholm, Sweden. · University of Sheffield, Sheffield, UK. · City of Hope Cancer Center, Duarte, CA, USA. · University of Padua, Padua, Italy. · Peter MacCallum Cancer Centre, Melbourne, Australia. ·Eur Urol · Pubmed #25595099.

ABSTRACT: BACKGROUND: The technique of robot-assisted radical cystectomy (RARC) has evolved significantly since its inception >10 yr ago. Several high-volume centers have reported standardized techniques with refinements and subsequent outcomes. OBJECTIVE: To review all existing literature on RARC and urinary diversion techniques and summarize key points that may affect oncologic, surgical, and functional outcomes. DESIGN, SETTING, AND PARTICIPANTS: The Pasadena Consensus Panel on RARC and urinary reconstruction convened May 3-4, 2014, to review the existing peer-reviewed literature and create recommendations for best practice. The panel consisted of experts in open radical cystectomy and RARC. No commercial support was received. SURGICAL PROCEDURE: The consensus panel extensively reviewed the surgical technique of RARC in men and women, extended pelvic lymph node dissection, extracorporeal urinary diversion, and intracorporeal urinary diversion. Critical aspects of the technique are described. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Preoperative, operative, and postoperative parameters from the largest and most contemporary RARC series, stratified by urinary diversion technique, are presented. RESULTS AND LIMITATIONS: Preoperative, operative, and postoperative measures of RARC technique adhere closely to the standards established in open surgery. CONCLUSIONS: Refinement of techniques for RARC and urinary diversion over the past 10 yr has made it safe, reproducible, and oncologically sound. PATIENT SUMMARY: We summarize the critical aspects of surgical techniques reviewed at the Pasadena international consensus meeting on RARC and urinary reconstruction. Preoperative, operative, and postoperative measures of RARC technique adhere closely to the standards established in open surgery.

2 Guideline Best practices in robot-assisted radical cystectomy and urinary reconstruction: recommendations of the Pasadena Consensus Panel. 2015

Wilson, Timothy G / Guru, Khurshid / Rosen, Raymond C / Wiklund, Peter / Annerstedt, Magnus / Bochner, Bernard H / Chan, Kevin G / Montorsi, Francesco / Mottrie, Alexandre / Murphy, Declan / Novara, Giacomo / Peabody, James O / Palou Redorta, Joan / Skinner, Eila C / Thalmann, George / Stenzl, Arnulf / Yuh, Bertram / Catto, James / Anonymous4100817. ·City of Hope Cancer Center, Duarte, CA, USA. Electronic address: twilson@coh.org. · Roswell Park Cancer Institute, Buffalo, NY, USA. · New England Research Institutes, Inc., Watertown, MA, USA. · Karolinska Institutet, Stockholm, Sweden. · Urology STHLM, Stockholm, Sweden. · Memorial Sloan-Kettering Cancer Center, New York, NY, USA. · City of Hope Cancer Center, Duarte, CA, USA. · University Vita-Salute San Raffaele, Milan, Italy. · O.L.V. Clinic, Aalst, Belgium. · Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia. · University of Padua, Padua, Italy. · Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA. · Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain. · Stanford University, Stanford, CA, USA. · University of Bern, Bern, Switzerland. · Eberhard Karls University of Tübingen, Tubingen, Germany. · University of Sheffield, Sheffield, UK. ·Eur Urol · Pubmed #25582930.

ABSTRACT: CONTEXT: Robot-assisted surgery is increasingly used for radical cystectomy (RC) and urinary reconstruction. Sufficient data have accumulated to allow evidence-based consensus on key issues such as perioperative management, comparative effectiveness on surgical complications, and oncologic short- to midterm outcomes. OBJECTIVE: A 2-d conference of experts on RC and urinary reconstruction was organized in Pasadena, California, and the City of Hope Cancer Center in Duarte, California, to systematically review existing peer-reviewed literature on robot-assisted RC (RARC), extended lymphadenectomy, and urinary reconstruction. No commercial support was obtained for the conference. EVIDENCE ACQUISITION: A systematic review of the literature was performed in agreement with the PRISMA statement. EVIDENCE SYNTHESIS: Systematic literature reviews and individual presentations were discussed, and consensus on all key issues was obtained. Most operative, intermediate-term oncologic, functional, and complication outcomes are similar between open RC (ORC) and RARC. RARC consistently results in less blood loss and a reduced need for transfusion during surgery. RARC generally requires longer operative time than ORC, particularly with intracorporeal reconstruction. Robotic assistance provides ergonomic value for surgeons. Surgeon experience and institutional volume strongly predict favorable outcomes for either open or robotic techniques. CONCLUSIONS: RARC appears to be similar to ORC in terms of operative, pathologic, intermediate-term oncologic, complication, and most functional outcomes. RARC consistently results in less blood loss and a reduced need for transfusion during surgery. RARC can be more expensive than ORC, although high procedural volume may attenuate this difference. PATIENT SUMMARY: Robot-assisted radical cystectomy (RARC) is an alternative to open surgery for patients with bladder cancer who require removal of their bladder and reconstruction of their urinary tract. RARC appears to be similar to open surgery for most important outcomes such as the rate of complications and intermediate-term cancer-specific survival. Although RARC has some ergonomic advantages for surgeons and may result in less blood loss during surgery, it is more time consuming and may be more expensive than open surgery.

3 Editorial Robotic radical cystectomy with intracorporeal neobladder: ready for prime time? 2013

Murphy, Declan G / Anderson, Paul. ·The Peter MacCallum Cancer Centre, Melbourne, Australia; Royal Melbourne Hospital, Melbourne, Australia; Australian Prostate Cancer Research Centre, Epworth Richmond Hospital, Melbourne, Australia. Electronic address: declan.murphy@petermac.org. ·Eur Urol · Pubmed #23831008.

ABSTRACT: -- No abstract --

4 Editorial Editorial comment. 2010

Murphy, Declan G. · ·J Urol · Pubmed #20083284.

ABSTRACT: -- No abstract --

5 Review Enhanced Recovery After Surgery protocols for radical cystectomy surgery: review of current evidence and local protocols. 2015

Mir, Maria C / Zargar, Homayoun / Bolton, Damien M / Murphy, Declan G / Lawrentschuk, Nathan. ·Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA. · Urology Department, Miller School of Medicine, University of Miami, Florida, USA. · Austin Health, The University of Melbourne, Melbourne, Victoria, Australia. · Peter MacCallum Cancer Center, The University of Melbourne, Melbourne, Victoria, Australia. · Olivia Newton-John Cancer Research Institute, Austin Health, The University of Melbourne, Melbourne, Victoria, Australia. ·ANZ J Surg · Pubmed #25781409.

ABSTRACT: BACKGROUND: Radical cystectomy (RC) remains a morbid procedure. The use of Enhanced Recovery After Surgery (ERAS) pathways has proven to reduce care time and post-operative complications after colorectal surgery. There is a high potential for reducing morbidity associated with RC by utilizing ERAS in this setting. The purpose of this review is to examine the current evidence for ERAS in preoperative, intra-operative and post-operative setting of care for RC patients and to propose ERAS evidence-based protocol for patients undergoing RC in the Australian and New Zealand environment. PREOPERATIVE: Patient's medical optimization, avoidance of oral mechanical bowel preparation and emphasis on preoperative administration of high-energy carbohydrate drinks from colorectal literature has led to inclusion of these strategies in the preoperative considerations of ERAS in RC. INTRA-OPERATIVE: Epidural analgesia has an integral role in reducing surgical stress response, improving analgesia and expediting functional recovery and should be included in ERAS RC protocols. Of relevance is 72 h maximum length of its duration. With regard to minimally invasive approach to RC, despite encouraging results from high-volume centres, high-level evidence in this field are lacking (ongoing clinical trials). Standardized anaesthetic protocols with particular emphasis on perioperative fluid management are essential components of ERAS protocols. POST-OPERATIVE: Avoidance of routine nasogastric tube placement, early mobilization and multifaceted approach to optimization of gut function and elimination of post-operative ileus are the cornerstones of post-operative care in the setting of ERAS in RC patients.

6 Review Systematic review and cumulative analysis of perioperative outcomes and complications after robot-assisted radical cystectomy. 2015

Novara, Giacomo / Catto, James W F / Wilson, Timothy / Annerstedt, Magnus / Chan, Kevin / Murphy, Declan G / Motttrie, Alexander / Peabody, James O / Skinner, Eila C / Wiklund, Peter N / Guru, Khurshid A / Yuh, Bertram. ·Department of Surgery, Oncology, and Gastroenterology - Urology Clinic, University of Padua, Italy. Electronic address: giacomonovara@gmail.com. · Academic Urology Unit, University of Sheffield, Sheffield, UK. · City of Hope National Cancer Center Duarte, CA, USA. · Department of Urology, Herlev University Hospital, Denmark. · Division of Cancer Surgery, Peter MacCallum Cancer Centre, St. Andrews Place, East Melbourne, Victoria, Australia. · Department of Urology, Onze-Lieve-Vrouw Hospital, Aalst, Belgium. · Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA. · Department of Urology, Stanford University, Stanford, CA, USA. · Karolinska University Hospital, Urology, Stockholm, Sweden. · Department of Urology, Roswell Park Cancer Institute, Buffalo, NY, USA. ·Eur Urol · Pubmed #25560798.

ABSTRACT: CONTEXT: Although open radical cystectomy (ORC) is still the standard approach, laparoscopic radical cystectomy (LRC) and robot-assisted radical cystectomy (RARC) have gained popularity. OBJECTIVE: To report a systematic literature review and cumulative analysis of perioperative outcomes and complications of RARC in comparison with ORC and LRC. EVIDENCE ACQUISITION: Medline, Scopus, and Web of Science databases were searched using a free-text protocol including the terms robot-assisted radical cystectomy or da Vinci radical cystectomy or robot* radical cystectomy. RARC case series and studies comparing RARC with either ORC or LRC were collected. Cumulative analysis was conducted. EVIDENCE SYNTHESIS: The searches retrieved 105 papers. According to the different diversion type, overall mean operative time ranged from 360 to 420 min. Similarly, mean blood loss ranged from 260 to 480 ml. Mean in-hospital stay was about 9 d for all diversion types, with consistently high readmission rates. In series reporting on RARC with either extracorporeal or intracorporeal conduit diversion, overall 90-d complication rates were 59% (high-grade complication: 15%). In series reporting RARC with intracorporeal continent diversion, the overall 30-d complication rate was 45.7% (high-grade complication: 28%). Reported mortality rates were ≤3% for all diversion types. Comparing RARC and ORC, cumulative analyses demonstrated shorter operative time for ORC, whereas blood loss and in-hospital stay were better with RARC (all p values <0.003). Moreover, 90-d complication rates of any-grade and 90-d grade 3 complication rates were lower for RARC (all p values <0.04), whereas high-grade complication and mortality rates were similar. CONCLUSIONS: RARC can be performed safely with acceptable perioperative outcome, although complications are common. Cumulative analyses demonstrated that operative time was shorter with ORC, whereas RARC may provide some advantages in terms of blood loss and transfusion rates and, more limitedly, for postoperative complication rates over ORC and LRC. PATIENT SUMMARY: Although open radical cystectomy (RC) is still regarded as a standard treatment for muscle-invasive bladder cancer, laparoscopic and robot-assisted RC are becoming more popular. Robotic RC can be safely performed with acceptably low risk of blood loss, transfusion, and intraoperative complications; however, as for open RC, the risk of postoperative complications is high, including a substantial risk of major complication and reoperation.

7 Article Words of wisdom. Re: A new concept for early recovery after surgery in patients undergoing radical cystectomy for bladder cancer: results of a prospective randomized study. 2014

Sapre, Nikhil / Murphy, Declan G. ·Department of Urology and Surgery, University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia. · Department of Urology and Surgery, University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia; Division of Cancer Surgery, University of Melbourne, Peter MacCallum Cancer Centre, Melbourne, Australia; Epworth Prostate Centre, Epworth Healthcare, Richmond, Australia. Electronic address: declan.murphy@petermac.org. ·Eur Urol · Pubmed #25305790.

ABSTRACT: -- No abstract --

8 Article Long-term outcomes of robot-assisted radical cystectomy for bladder cancer. 2013

Khan, Muhammad Shamim / Elhage, Oussama / Challacombe, Benjamin / Murphy, Declan / Coker, Bola / Rimington, Peter / O'Brien, Timothy / Dasgupta, Prokar. ·Urology Centre, Guy's & St Thomas' NHS Foundation Trust, Great Maze Pond, London SE1 9RT, United Kingdom. ·Eur Urol · Pubmed #23395594.

ABSTRACT: BACKGROUND: Long-term oncologic and functional outcomes after robot-assisted radical cystectomy (RARC) for bladder cancer (BCa) are lacking. OBJECTIVE: To report oncologic and functional outcomes in a cohort of patients who have completed a minimum of 5 yr and a maximum of 8 yr of follow-up after RARC and extracorporeal urinary diversion. DESIGN, SETTING, AND PARTICIPANTS: In this paper, we report on the experience from one of the first European urology centres to introduce RARC. Only patients between 2004 and 2006 were included to ensure follow-up of ≥ 5 yr. We report on an analysis of oncologic outcomes in 14 patients (11 males and 3 females) with muscle-invasive/high-grade non-muscle-invasive or bacillus Calmette-Guérin-refractory carcinoma in situ who opted to have RARC. INTERVENTION: RARC with pelvic lymphadenectomy was performed using the three-arm standard da Vinci Surgical System (Intuitive Surgical, CA, USA). Urinary diversion, either ileal conduit (n=12) or orthotopic neobladder (n=2), was constructed extracorporeally. OUTCOME MEASUREMENTS: Parameters were recorded in a prospectively maintained database including assessment of renal function, overall survival, disease-specific survival, development of metastases, and functional outcomes. STATISTICAL ANALYSIS: Results were analysed using descriptive statistical analysis. Survival data were analysed and presented using the Kaplan-Meier survival curve. RESULTS AND LIMITATIONS: Five of the 14 patients have died. Three patients died of metastatic disease, and two died of unrelated causes. Two other patients are alive with metastases, and another has developed primary lung cancer. Six patients are alive and disease-free. These results show overall survival of 64%, disease-specific survival of 75%, and disease-free survival of 50%. None of the patients had deterioration of renal function necessitating renal replacement therapy. Three of four previously potent patients having nerve-sparing RARC recovered erectile function. The study is limited by the relatively small number of highly selected patients undergoing RARC, which was a novel technique 8 yr ago. The standard da Vinci Surgical System made extended lymphadenectomy difficult. CONCLUSIONS: Within limitations, in our experience RARC achieved excellent control of local disease, but the outcomes in patients with metastatic disease seem to be equivalent to the outcomes of open radical cystectomy.